Overall, this rotation was a great transition from my general medicine rotations in family medicine, pediatrics, and OB/GYN, encompassing many things from the rotations (except pediatrics). I felt that the rotation closely mirrored family medicine with the integration of managing patients in SAR (sub-acute rehab), the art of de-prescribing, palliative/comfort-care, and more.

During my time in geriatrics, I continued to strengthen my ability to manage multiple chronic conditions simultaneously, similar to family medicine, while further refining my clinical reasoning and medication management skills in elderly patients. One of the most valuable lessons I learned during this rotation was how to appropriately balance treatment goals with quality of life, especially when deciding whether certain medications should be tapered or discontinued due to risks outweighing benefits in the geriatric population. I was also able to become involved in the subacute rehabilitation setting, which was a new and rewarding experience for me, as I was able to follow patients from admission through discharge and observe their progression over time. In addition to chronic disease management, I was able to evaluate and help manage more acute concerns such as suspected small bowel obstruction, falls, syncope, suicidal ideations, abdominal complaints, and changes in mental status.

Procedurally, I gained hands-on experience performing several rectal exams for suspected fecal impaction, Foley catheter changes, G-tube changes, IV placements, bladder scans, and wound care dressing changes. Given the complexity of this patient population, I was also able to frequently practice focused neurologic and musculoskeletal exams, which significantly improved my confidence, especially when evaluating patients with neurologic conditions like Parkinson’s disease. This rotation also helped me become more comfortable recognizing subtle changes in elderly patients, as they often present differently than younger populations and may have atypical symptoms.

Throughout my rotation, I received valuable feedback from my preceptors regarding deprescribing practices, medication reconciliation, and understanding how certain medications can have detrimental effects in elderly patients, including increased fall risk, cognitive impairment, orthostasis, and functional decline. I was also able to participate in family discussions regarding palliative care and end-of-life goals, which helped me better appreciate the importance of compassionate communication and patient-centered care in geriatrics. Participating in daily morning reports on residents across multiple floors further strengthened my clinical reasoning skills, broadened my exposure to medically complex patients, and increased my confidence in managing geriatric cases in both acute and long-term care settings.

Overall, I found this rotation to be both rewarding and educational. The residents were often appreciative of the care they received, which made the experience especially meaningful. Working in the geriatric setting exposed me to a unique patient population with complex medical, functional, and psychosocial needs that required thoughtful and individualized care. I felt that learning from geriatric cases helped me become a more well-rounded clinician by improving my ability to manage polypharmacy, recognize subtle presentations of disease, communicate with families about goals of care, and balance aggressive treatment with maintaining patient comfort, safety, and quality of life.